Trends in knee magnetic resonance imaging, arthroscopies and joint replacements in older Australians: still too much low‐value care?

Abstract

Background: The objective of the study is to describe temporal trends and regional variations in the use of knee magnetic resonance imaging (MRI), knee arthroscopy and total knee replacement surgery in Australians older than 55 years.

Trends in management of hip and knee osteoarthritis in general practice in Australia over an 11-year window: a nationwide cross-sectional survey

“…This increase aligns with findings using Medicare Benefits Scheme claims data in Australians aged over 55 years. 19 Thus GP education should emphasise that imaging in OA should be reserved for cases where a differential diagnosis needs to be excluded or if joint replacement surgery is being considered.…”

“…Temporal trends reported in a retrospective study using Australian Medicare Benefits Scheme claims data from 2003 to 2017 showed that knee arthroscopy rates increased from 2003 before declining modestly from 2011, likely due to accumulating evidence that did not support its ongoing use, 20 while joint replacement rates have continued to increase. 19 GP referrals to orthopaedic surgeons remained more than double those to allied health professionals.…”

Osteoarthritis year in review 2020: epidemiology & therapy

“…The authors highlight the absence of good data on the size of the candidate population without which it may be difficult to decide on what should be the appropriate rate of procedures. Nevertheless, up to 10-fold variation in rates between different parts of the country suggests a very patchy response within a single healthcare system, a finding that studies in Australia 90 and France 91 appear to support.…”

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

“…The results are presented in Fig. 2 [ 20 – 23 , 26 – 29 , 35 , 40 – 42 , 54 , 64 , 68 , 69 , 122 , 123 , 125 , 127 – 130 , 140 , 141 , 143 , 145 – 147 , 157 – 159 , 172 – 174 , 176 , 177 , 179 , 182 , 190 , 210 , 211 , 213 , 215 , 216 , 229 , 242 , 252 , 277 , 284 , 353 – 387 ]. From these studies, imaging examinations with a high proportion of low-value examinations (more than 50% inappropriate use reported) was: Head CT (routine and repeat), routine trauma scan, MRI in musculoskeletal pain, dual-energy x-ray absorptiometry (DEXA) in low risk patients or low interval DEXA follow-ups, echocardiography, carotid imaging, chest X-ray, X-ray in acute rhinosinusitis, CTA in pulmonary embolism, early-stage breast cancer staging, acute pancreatitis, and special imaging for pre-op templar bone CT in cochlear implantation, and CT/MRI in long bone cartilaginous lesions.…”